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Falk-Brynhildsen, KarinORCID iD iconorcid.org/0000-0001-7862-3652
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Publications (10 of 18) Show all publications
von Vogelsang, A.-C., Swenne, C. L., Gustafsson, B. Å. & Falk-Brynhildsen, K. (2020). Operating theatre nurse specialist competence to ensure patient safety in the operating theatre: A discursive paper. Nursing Open, 7(2), 495-502
Open this publication in new window or tab >>Operating theatre nurse specialist competence to ensure patient safety in the operating theatre: A discursive paper
2020 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 7, no 2, p. 495-502Article in journal (Refereed) Published
Abstract [en]

Aim: To discuss specialist operating theatre nurses' competence in relation to the general six core competencies and patient safety.

Design: A discursive analysis of legal statutes and scientific articles.

Methods: Swedish legal statutes and an overview of scientific articles on operating theatre nursing were deductively analysed and classified into healthcare providers' general six core competencies.

Results: All healthcare professionals should possess the general core competencies, regardless of their discipline. The specific content within these competencies differs between disciplines. The specialized operating theatre nurse is the only healthcare professional having the competence to be responsible for asepsis, instrumentation, infection and complication, control and management of biological specimens during the surgical procedure. Besides operating theatre nurses, no other healthcare profession has the formal education, competence or skills to perform operating theatre nursing care in the theatre during the surgical procedure. Operating theatre nurse competence is therefore indispensable to ensure patient safety during surgery.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
Evidence-based practice, informatics, interdisciplinary health team, operating room nursing, patient safety, patient-centred care, quality improvement
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-78520 (URN)10.1002/nop2.424 (DOI)000498437600001 ()32089845 (PubMedID)2-s2.0-85076202847 (Scopus ID)
Note

Funding Agency:

Swedish Operating Room Nurses Association (SEORNA) 

Available from: 2019-12-10 Created: 2019-12-10 Last updated: 2020-03-03Bibliographically approved
Larsson, H., Hälleberg Nyman, M., Friberg, Ö. & Falk-Brynhildsen, K. (2020). Perioperative routines and surgical techniques for saphenous vein harvesting in CABG surgery: a national cross-sectional study in Sweden. Journal of Cardiothoracic Surgery, 15(1), Article ID 5.
Open this publication in new window or tab >>Perioperative routines and surgical techniques for saphenous vein harvesting in CABG surgery: a national cross-sectional study in Sweden
2020 (English)In: Journal of Cardiothoracic Surgery, ISSN 1749-8090, E-ISSN 1749-8090, Vol. 15, no 1, article id 5Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The saphenous vein is the most commonly used conduit for coronary artery bypass grafting (CABG). Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2 to 20%. Patients' risk factors, perioperative hygiene routines, and surgical technique play important roles in wound complications. Here we describe the perioperative routines and surgical methods of Swedish operating theatre (OT) nurses and cardiac surgeons.

METHODS: A national cross-sectional survey with descriptive design was conducted to evaluate perioperative hygiene routines and surgical methods associated with saphenous vein harvesting in CABG. A web-based questionnaire was sent to OT nurses and cardiac surgeons at all eight hospitals performing CABG surgery in Sweden.

RESULTS: Responses were received from all hospitals. The total response rate was 62/119 (52%) among OT nurses and 56/111 (50%) among surgeons. Chlorhexidine 5 mg/mL in 70% ethanol was used at all eight hospitals. The OT nurses almost always (96.8%) performed the preoperative skin disinfection, usually for three to 5 minutes. Chlorhexidine was also commonly used before dressing the wound. Conventional technique was used by 78.6% of the surgeons, "no-touch" by 30.4%, and both techniques by 9%. None of the surgeons used endoscopic vein harvesting. Type of suture and technique used for closing the wound differed markedly between the centres.

CONCLUSIONS: In this article we present insights into the hygiene routines and surgical methods currently used by OT nurses and cardiac surgeons in Sweden. The results indicate both similarities and differences between the centres. Local traditions might be the most important factors in determining which procedures are employed in the OT. There is a lack of evidence-based hygiene routines and surgical methods.

Place, publisher, year, edition, pages
BioMed Central, 2020
Keywords
Perioperative hygiene routines, Surgical methods, Vein harvesting
National Category
Surgery Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-78965 (URN)10.1186/s13019-020-1056-y (DOI)000512192500006 ()31915020 (PubMedID)2-s2.0-85077702093 (Scopus ID)
Note

Funding Agency:

Örebro University Hospital research committee and Örebro University

Available from: 2020-01-14 Created: 2020-01-14 Last updated: 2020-02-28Bibliographically approved
Falk-Brynhildsen, K., Jaensson, M., Gillespie, B. M. & Nilsson, U. (2019). Differences in Perceptions of Competence and Self-Efficacy between Operating Room Nurses and Nurse Anesthetists. In: : . Paper presented at 5th International Conference for PeriAnaesthesia Nurses (ICPAN 2019), Cancun, Mexico, November 5-8, 2019.
Open this publication in new window or tab >>Differences in Perceptions of Competence and Self-Efficacy between Operating Room Nurses and Nurse Anesthetists
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: In the Operating room environment, it is most important how individuals experience specific knowledge and how they solve the complex tasks in perioperative practice, to enhance safe clinical practice. The purpose of this study was to compare perceived competence and self-efficacy (SE) among Swedish operating room (OR) nurses and registered nurse anesthetists (RNAs), and to evaluate the relationship between SE and competence, gender, age, and years of experience. In a comparative cross‐sectional design, an online questionnaire was sent to the members of the Swedish Association of Health Professionals (n 2,902). With n=1,033 responses, a response rate of 39% perioperative nurses was achieved (505 OR nurses and 528 RNAs). A Swedish translation of the instrument Perceived Perioperative Competence Scale-Revised (PPCS-R) measuring perceived competence, and the General self-efficacy (GSE) scale was used. OR nurses showed significantly higher scores on two of the six PPCS-R subscales, foundational knowledge and leadership as well as GSE scores compared with RNAs. The RNA group showed significantly higher empathy scores compared with OR nurses. Among the OR nurses, professional development made the strongest contribution to SE and proficiency among the RNAs. This result indicates differences in perceived competence and SE between OR nurses and RNAs and also suggests that gender may be an independent factor affecting self-efficacy and proficiency among the RNAs.

Implications for practice: Based on our findings the presentation may provide a positive impact, highlighting the importance of reflecting on and to measure self-reported perioperative competence and SE, thus allowing both the team and the individual to identify areas where education and training are necessary to ensure safe care. The findings can also be an opportunity for managers and leaders using the results to strengthen and improve perioperative care to enhance safe clinical practice.

National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-78818 (URN)
Conference
5th International Conference for PeriAnaesthesia Nurses (ICPAN 2019), Cancun, Mexico, November 5-8, 2019
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-01-07Bibliographically approved
Wistrand, C., Söderquist, B., Falk-Brynhildsen, K. & Nilsson, U. (2018). Exploring bacterial growth and recolonization after preoperative hand disinfection and surgery between operating room nurses and non-health care workers: a pilot study. BMC Infectious Diseases, 18(1), Article ID 466.
Open this publication in new window or tab >>Exploring bacterial growth and recolonization after preoperative hand disinfection and surgery between operating room nurses and non-health care workers: a pilot study
2018 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 18, no 1, article id 466Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To prevent cross infection the surgical team perform preoperative hand disinfection before dressed in surgical gowns and gloves. Preoperative hand disinfection does not make hands sterile and the surgical glove cuff end has been regarded as a weak link, since it is not a liquid-proof interface. The aims were to investigate if there were differences in bacterial growth and recolonization of hands between operating room nurses and non-health care workers as well as to investigate if bacterial growth existed at the surgical glove cuff end during surgery.

METHODS: This pilot project was conducted as an exploratory comparative clinical trial. Bacterial cultures were taken from the glove and gown interface and at three sites of the hands of 12 operating room nurses and 13 non-health care workers controls directly after preoperative hand disinfection and again after wearing surgical gloves and gowns. Colony forming units were analysed with Mann-Whitney U test and Wilcoxon Sign Ranks test comparing repeated measurements. Categorical variables were evaluated with chi-square test or Fisher's exact test.

RESULTS: Operating room nurses compared to non-health care workers had significant higher bacterial growth at two of three culture sites after surgical hand disinfection. Both groups had higher recolonization at one of the three culture sites after wearing surgical gloves. There were no differences between the groups in total colony forming units, that is, all sampling sites. Five out of 12 of the operating room nurses had bacterial growth at the glove cuff end and of those, four had the same bacteria at the glove cuff end as found in the cultures from the hands. Bacteria isolated from the glove cuff were P. acnes, S. warneri, S. epidermidis and Micrococcus species, the CFU/mL ranged from 10 to 40.

CONCLUSIONS: There were differences in bacterial growth and re-colonization between the groups but this was inconclusive. However, bacterial growth exists at the glove cuff and gown interface, further investigation in larger study is needed, to build on these promising, but preliminary, findings.

TRIAL REGISTRATION: Trial registration was performed prospectively at Research web (FOU in Sweden, 117,971) 14/01/2013, and retrospectively at ClinicalTrials.gov ( NCT02359708 ). 01/27/2015.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Bacterial growth, Bacterial re-colonization, Cross infection, Hand disinfection, Intraoperative, Preoperative, Surgery, Surgical gloves, Surgical site infections
National Category
Infectious Medicine Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-69132 (URN)10.1186/s12879-018-3375-3 (DOI)000444938900001 ()30223772 (PubMedID)2-s2.0-85053382679 (Scopus ID)
Note

Funding Agencies:

Research Committee of Örebro County Council  

Örebro University, Sweden 

Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-04Bibliographically approved
Wistrand, C., Falk-Brynhildsen, K. & Nilsson, U. (2018). National Survey of Operating Room Nurses' Aseptic Techniques and Interventions for Patient Preparation to Reduce Surgical Site Infections. Surgical Infections, 19(4), 438-445
Open this publication in new window or tab >>National Survey of Operating Room Nurses' Aseptic Techniques and Interventions for Patient Preparation to Reduce Surgical Site Infections
2018 (English)In: Surgical Infections, ISSN 1096-2964, E-ISSN 1557-8674, Vol. 19, no 4, p. 438-445Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Surgical site infection (SSI), the third most common type of nosocomial infection in Sweden, is a patient injury that should be prevented. Methods of reducing SSIs include, for instance, disinfecting the skin, maintaining body temperature, and ensuring an aseptic environment. Guidelines for most of these interventions exist, but there is a lack of studies describing to what extent the preventive interventions have been implemented in clinical practice. We describe the daily clinical interventions Swedish operating room (OR) nurses performed to prevent SSIs following national guidelines.

METHODS: A descriptive cross-sectional study using a Web-based questionnaire was conducted among Swedish OR nurses. The study-specific questionnaire included 32 items addressing aspects of the interventions performed to prevent SSI, such as preparation of the patient skin (n = 12), maintenance of patient temperature (n = 10), and choice of materials (n = 10). The response format included both closed and open-ended answers.

RESULTS: In total, 967 nurses (43% of the total) answered the questionnaire; of these, 77 were excluded for various reasons. The proportions of the OR nurses who complied with the preventive interventions recommended in the national guidelines were high: skin disinfection solution (93.5%), sterile drapes (97.4%) and gowns (83.8%) for single use, and the use of double gloves (73.0%). However, when guidelines were lacking, some interventions differed, such as the frequency of glove changes and the use of adhesive plastic drapes.

CONCLUSION: To standardize OR nurses' preventive interventions, implementing guidelines seems to be the key priority. Overall, OR nurses have high compliance with the national guidelines regarding interventions to prevent bacterial growth and SSIs in the surgical patient. However, when guidelines are lacking, the preventive interventions lose conformity.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2018
Keywords
Patient preparation, skin disinfection, surgical site infection
National Category
Surgery Infectious Medicine
Identifiers
urn:nbn:se:oru:diva-66708 (URN)10.1089/sur.2017.286 (DOI)000430589700001 ()29672240 (PubMedID)2-s2.0-85047351296 (Scopus ID)
Available from: 2018-04-23 Created: 2018-04-23 Last updated: 2018-10-09Bibliographically approved
Gillespie, B. M., Harbeck, E. B., Falk-Brynhildsen, K., Nilsson, U. & Jaensson, M. (2018). Perceptions of perioperative nursing competence: a cross-country comparison. BMC Nursing, 17, Article ID 12.
Open this publication in new window or tab >>Perceptions of perioperative nursing competence: a cross-country comparison
Show others...
2018 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 17, article id 12Article in journal (Refereed) Published
Abstract [en]

Background: Throughout many countries, professional bodies rely on yearly self-assessment of competence for ongoing registration; therefore, nursing competence is pivotal to safe clinical practice. Our aim was to describe and compare perioperative nurses' perceptions of competence in four countries, while examining the effect of specialist education and years of experience in the operating room.

Methods: We conducted a secondary analysis of cross-sectional surveys from four countries including; Australia, Canada, Scotland, and Sweden. The 40-item Perceived Perioperative Competence Scale-Revised (PPCS-R), was used with a total sample of 768 respondents. We used a factorial design to examine the influence of country, years of experience in the operating room and specialist education on nurses' reported perceived perioperative competence.

Results: Regardless of country origin, nurses with specialist qualifications reported higher perceived perioperative competence when compared to nurses without specialist education. However, cross-country differences were dependent on nurses' number of years of experience in the operating room. Nurses from Sweden with 6-10 years of experience in the operating room reported lower perceived perioperative competence when compared to Australian nurses. In comparing nurses with >10 years of experience, Swedish nurses reported significantly lower perceived perioperative competence when compared to nurses from Australia, Canada and Scotland.

Conclusion: Researchers need to consider educational level and years of experience in the perioperative context when examining constructs such as competence.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Perioperative nursing; Competence; Cross-national; Survey; Patient safety
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-66346 (URN)10.1186/s12912-018-0284-0 (DOI)000429063700001 ()29632435 (PubMedID)2-s2.0-85044847473 (Scopus ID)
Available from: 2018-04-04 Created: 2018-04-04 Last updated: 2019-03-26Bibliographically approved
Jaensson, M., Falk-Brynhildsen, K., Gillespie, B. M., Wallentin, F. Y. & Nilsson, U. (2018). Psychometric Validation of the Perceived Perioperative Competence Scale-Revised in the Swedish Context. Journal of Perianesthesia Nursing, 33(4), 499-511
Open this publication in new window or tab >>Psychometric Validation of the Perceived Perioperative Competence Scale-Revised in the Swedish Context
Show others...
2018 (English)In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 4, p. 499-511Article in journal (Refereed) Published
Abstract [en]

Purpose: To psychometrically test the Perceived Perioperative Competence Scale-Revised (PPCS-R) in the Swedish context.

Design: Cross-sectional survey.

Methods: The 40-item PPCS-R was translated into Swedish using a forward-translation approach. A census of 2,902 registered nurse anesthetists (RNAs) and operating room (OR) nurses was drawn from a database of a national association in Sweden.

Finding: The response rate was 39% (n = 1,033; 528 RNAs and 505 OR nurses). Cronbach alpha for each factor was 0.78 to 0.89 among OR nurses and 0.79 to 0.88 among RNAs. Confirmatory factor analysis showed good model fit in the six-factor model.

Conclusions: Psychometric testing of the Swedish translation of the PPCS-R suggests a good construct validity, and the construct and its six factors are conceptually relevant among the Swedish OR nurses and RNAs.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
instrument development, nursing competence, advanced practice nursing, confirmatory factor analysis
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-56963 (URN)10.1016/j.jopan.2016.09.012 (DOI)000440398700104 ()30077294 (PubMedID)2-s2.0-85017190340 (Scopus ID)
Available from: 2017-04-06 Created: 2017-04-06 Last updated: 2019-03-26Bibliographically approved
Nilsson, U., Falk-Brynhildsen, K. & Jaensson, M. (2017). Hur har ni det med kompetensen?. In: : . Paper presented at AnIva Höstkongress 2017, 23-24 November, 2017, Upplands Väsby, Sweden,.
Open this publication in new window or tab >>Hur har ni det med kompetensen?
2017 (Swedish)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:oru:diva-62680 (URN)
Conference
AnIva Höstkongress 2017, 23-24 November, 2017, Upplands Väsby, Sweden,
Available from: 2017-11-19 Created: 2017-11-19 Last updated: 2019-04-05Bibliographically approved
Nilsson, U., Falk Brynhildsen, K. & Jaensson, M. (2016). Hur har ni det med kompetensen?. In: : . Paper presented at Höstkongress 2016. Riksföreningen för operationssjukvård. Stockholm, 1-2 december, 2016.
Open this publication in new window or tab >>Hur har ni det med kompetensen?
2016 (Swedish)Conference paper, Oral presentation with published abstract (Other (popular science, discussion, etc.))
National Category
Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:oru:diva-53724 (URN)
Conference
Höstkongress 2016. Riksföreningen för operationssjukvård. Stockholm, 1-2 december, 2016
Available from: 2016-12-01 Created: 2016-12-01 Last updated: 2017-10-18Bibliographically approved
Falk-Brynhildsen, K., Söderquist, B., Friberg, Ö. & Nilsson, U. (2014). Bacterial growth and wound infection following saphenous vein harvesting in cardiac surgery: a randomized controlled trial of the impact of microbial sealant. European Journal of Clinical Microbiology and Infectious Diseases, 33(11), 1981-1987
Open this publication in new window or tab >>Bacterial growth and wound infection following saphenous vein harvesting in cardiac surgery: a randomized controlled trial of the impact of microbial sealant
2014 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 33, no 11, p. 1981-1987Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to compare microbial skin sealant versus bare skin on the leg regarding intraoperative bacterial presence in the surgical wound and time to recolonization of the adjacent skin at the saphenous vein harvesting site. A second aim was to evaluate the incidence of leg wound infection 2 months after surgery. In this randomized controlled trial, 140 patients undergoing coronary artery bypass grafting (CABG) between May 2010 and October 2011 were enrolled. Bacterial samples were taken preoperatively and intraoperatively at multiple time points and locations. OF the patients, 125 (92.6 %) were followed up 2 months postoperatively regarding wound infection. Intraoperative bacterial growth did not differ between the bare skin (n = 68) and the microbial skin sealant group (n = 67) at any time point. At 2 months postoperatively, 7/61 patients (11.5 %) in the skin sealant versus 14/64 (21.9 %) in the bare skin group (p = 0.120) had been treated with antibiotics for a verified or suspected surgical site infection (SSI) at the harvest site. We found almost no intraoperative bacterial presence on the skin or in the subcutaneous tissue, irrespective of microbial skin sealant use. In contrast, we observed a relatively high incidence of late wound infection, indicating that wound contamination occurred postoperatively. Further research is necessary to determine whether the use of microbial skin sealant reduces the incidence of leg wound infection at the saphenous vein harvest site.

Place, publisher, year, edition, pages
Springer, 2014
Keywords
intra-operative, skin sealant, saphenous vein graft harvesting, SSI, contamination
National Category
Infectious Medicine Microbiology in the medical area
Identifiers
urn:nbn:se:oru:diva-32650 (URN)10.1007/s10096-014-2168-x (DOI)000344071600014 ()24907853 (PubMedID)2-s2.0-84911005344 (Scopus ID)
Note

Funding agencies are:

Research Comittee of Örebro County Council

Nyckelfonden at Örebro University Hospital

Available from: 2013-12-06 Created: 2013-12-06 Last updated: 2018-08-27Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-7862-3652

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